Incomplete articular-side repair increase re-tear rate in full-thickness rotator cuff tears
Incomplete articular-side repair increase re-tear rate in full-thickness rotator cuff tears
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DOI：
10.1177/2309499018760113
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发表时间：
2018-02-27
影响因子：
1.6
通讯作者：
Han, Sun-Cheol
中科院分区：
文献类型：
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作者：
Kim, Kyung Cheon;Lee, Woo-Yong;Han, Sun-Cheol
目的：本研究根据全层撕裂的关节侧修复状态，比较了关节镜下肩袖修复的功能结果和修复完整性。方法：我们前瞻性地连续招募了 80 名前后尺寸肩袖全层撕裂 1.5-3.5 厘米的患者。根据术中关节端修复状态将患者分为两组：完全修复组和不完全修复组。术后6个月通过磁共振图像或超声检查评估修复完整性。术后1年和2年评估临床结果。本研究使用了四种结果测量：视觉模拟量表疼痛评分、美国肩肘外科医生 (ASES) 评分、加州大学洛杉矶分校 (UCLA) 肩部评定量表 (UCLA) 评分和运动范围。结果：2 年随访时，完整组的平均 UCLA、ASES 和恒定分数显着提高，分别为 32.46、87.94 和 79.69，不完整组分别为 32.50、87.65 和 78.92。术后两组的 UCLA、ASES 和恒定评分均有所改善（所有 ps < 0.000）；然而，两组之间没有显着差异（p 分别为 0.960、0.921 和 0.796）。完全修复的肩部再撕裂率为13.7%，不完全修复的肩部再撕裂率为33.3%；这种差异具有统计学意义（p = 0.041）。结论：无论关节侧肩袖的修复状态如何，关节镜下肩袖修复在短期随访中两组之间的功能结果相当。然而，关节侧肩袖修复不完全的患者术后再撕裂率高于完全修复的患者。
Purpose: This study compared the functional outcome and repair integrity of arthroscopic rotator cuff repair according to articular-side repair state in full-thickness tears. Methods: We prospectively enrolled 80 consecutive patients with full-thickness rotator cuff tears of 1.5-3.5 cm at the anterior to posterior dimension. These patients were divided into two groups according to intraoperative articular-side repair state during operation: complete and incomplete repair groups. Repair integrity was evaluated at 6 months after the operation by magnetic resonance image or ultrasonograp hy. Clinical outcomes were evaluated at 1 year and 2 years postoperatively. Four outcome measures were used in this study: visual analog scale pain score, American Shoulder and Elbow Surgeons (ASES) score, the Shoulder Rating Scale of the University of California at Los Angeles (UCLA) score, and range of motion. Results: At 2-year follow-up, the average UCLA, ASES, and constant score improved significantly to 32.46, 87.94, and 79.69, respectively, in the complete group and to 32.50, 87.65, and 78.92, respectively, in the incomplete group. The UCLA, ASES, and constant score improved in both groups postoperatively (all ps < 0.000); however, there was no significant difference between the two groups (p = 0.960, 0.921, and 0.796, respectively). The re-tear rate was 13.7% in the shoulders that underwent complete repair and 33.3% in the shoulders that underwent incomplete repair; this difference was statistically significant (p = 0.041). Conclusion: Regardless of the repair state of articular-side rotator cuff, the arthroscopic rotator cuff repair resulted in comparable functional outcomes between two groups at short-term follow-up. However, patients who repaired articular-side rotator cuff incompletely revealed higher re-tear rate after operation than those who repaired completely.